[Experiences of self-management of type I diabetes in adolescents: a phenomenological study]

Introduction: This study aimed to examine the concept of self-management of type I diabetes in adolescents

Materials and Methods: This study used the Van Manen's six-step hermeneutic phenomenological approach to examine the concept of self management of type-1 diabetes among Iranian adolescents, with the disorders Eight adolescents, aged 13-18 years, diagnosed with type I diabetes at least one year ago, were recruited. Mean age of the adolescents was 16 years, the mean duration of suffering was 3 years and 10 months and the mean length of interviews was 35 min, and 27 sec. Data were collected through semi-structured interviews. After each interview, data were analyzed by the research team. Each interview was a guide for the next interview, the questions of which were changed based on the data obtained from the previous interview. Field notes were also used as an instrument to collect data

Results: This study extracted 7 themes, including productive interaction, self-efficacy achievement, self-regulation achievement, overcoming problems, future prospects and "diabetes, a part of life", A theme not previously observed in other studies was maintaining appearances among these adolescents

Conclusion: This study showed that Iranian adolescents with diabetes type 1 are eager to participate in selfcare and self-management

[Related factors with academic burnout in nursing and paramedics students of Qom university of medical sciences in 2014]

Introduction: Academic burnout is the feeling of inadequacy and mental fatigue induced by chronic stress in students lacking the necessary resources to carry out their duties and tasks assigned to them. This study was conducted to determine the status of academic burnout and related factors

Method: In this cross-sectional study 264 students at nursing, anesthesia, operating room and medical emergencies were randomly selected. Demographic information - Education and Academic burnout was used to collect data. Reliability and validity of the scale was determined with Cronbach's. After entering data into SPSS version 16, we used descriptive statistics and logistic regression

Results: Mean [ +/- SD] score of the academic burnout of students participated in the study was [28.52 +/- 15.84] and overall 24.1% and 46.6% of students had high and moderate level of academic burnout respectively. Based on the results obtained from multivariate GPA [grade point average] in emotional exhaustion [OR:0.75 95%CI:0.58-0.96] and cynicism subscales [OR:0.73 95%CI:0.56-0.96] were significantly related to academic burnout and in inefficacy subscale GPA[OR:0.68 95%CI:0.5-0.92], residing at personal home [OR:4.10 95%CI:1.27-13.20] and studying anesthesiology [OR:3.19 95%CI:1.12-9.10] were significantly related to academic burnout [P<0.05]

Conclusion: Based on the findings of the present study a significant percentage of students were experiencing academic burnout. GPA had a protection role against academic burnout and studying anesthesia and living in your own home were risk factors for academic burnout. GPA scores for the two subscales were significantly related to emotional exhaustion and doubts, therefore planning to improve academic burnout can improve the academic performance of the students

[Gap analysis between expectations and perceptions on total quality management in private Gorgan's rehabilitation centers by using fuzzy logic]

Rehabilitation service is one the most important aspect of health system services. If quality is not appropriate, disability could increase in society. Total Quality Management [TQM] can make revolution to achieve the desired quality. The aim of this study was to determine gap analysis between expectations and perceptions on Total Quality Management in private Gorgan's rehabilitation centers by using Fuzzy logic. This study was a descriptive-analytical, survey. Samples were selected from staffs of private Gorgan's rehabilitation centers. Two survey questioners of "Measurement Gap between Expectations" and "Perceptions of TQM Components" was used. Validity of the questionnaires were measured by Content Validity Ratio [CVR] and Content Validity Index [CVI], which was 0.83 for both questionnaires and reliability was confirmed by internal consistency [alpha =0.932]. After collecting questionnaires, questionnaires were analyzed by SPSS/17, EXCEL 2007. The total fuzzy average of expectation with 0.822, 0.923, and 0.982values, was more than total fuzzy average of perceptions [0.59, 0.71, and 0.83]. Furthermore, findings showed a significant difference between expectations and perceptions in all factors of TQM. There was a significant difference between all factors of total quality management. It means that staffs mentioned present condition is lower than optimum condition and the organizations couldn't supply their staffs' expectations

client satisfaction of delivered services in private nursing homes for elderly: a survey in the provinces of Golestan, Mazandaran, Semnan and Northern Khorasan in 2012

Objective: In The last two decades, nursing homes for elderly have expanded tremendously. Client satisfaction is one of the most important indicators of service quality delivered by institutes and organizations. This study was carried out to measure client satisfaction in the private nursing homes of Golestan, Mazandaran, Semnan and Northern Khorasan Provinces in 2012

Methods: In this cross-sectional study, 89 participants from all 14 nursing homes located in the pre-mentioned provinces who met the inclusion criteria including age 60 years or older, ability to communicate, Abbreviated Mental Test scores of 6 or higher, and at least 6 months stay duration were recruited by the method of census and interviewed. Data was gathered using the questionnaire of Assessing Elderly Residents' Satisfaction of the Delivered Services in Nursing Homes. In order to analyze data, statistical parametric t-test, ANOVA, Mann-Whitney, Kruskal- Wallis test, Spearman correlation coefficient and SPSS software [version 17], were used

Results: Mean scores showed that satisfaction with the physical care [3.55] and physical environment [3.77] were higher than of satisfaction with psychological care [3.00] and social care [3.26]. The mean score of overall satisfaction with the services was 3.40 and indicative of satisfaction in the levels of moderate to good. There was a significant relation between mean scores of satisfaction and the way which clients had been admitted to nursing homes [p<0.002]

Conclusion: Lower levels of satisfaction with psychological and social care in the nursing homes points to the need of paying more attention toward these two care dimensions. Considering the significant relationship between self commitment and the level of satisfaction, psychological preparedness of older clients before committing them to nursing homes may play a role in their satisfaction with the services delivered in nursing home

[ relationship between knowledge and observance of patients' rights in rehabilitation centers of Tehran]

Patients, regardless of their age, sex, race, and other differences, have a right to knowledge, choice, respect, confidentiality, territoriality, and efficient care and treatment in health care settings. Rehabilitation experts, like other health care providers, should be knowledgeable and observant of these rights. This study was designed to determine the relationship between experts' knowledge of patients' rights and their level of observance of these rights. In this cross-sectional, descriptive and analytical study, all experts working in rehabilitation and welfare centers in the city of Tehran with at least 6 months work experience were included by census method. Sixty-two experts were examined by a questionnaire with confirmed validity and reliability, consisting of 2 subscales measuring knowledge and observance of the participants on patients' rights. Of all the participants, 79% were female and 77.4% had bachelor's degrees. The mean age was 35.9 [SD=8] years. Knowledge on patients' rights was at the very good level in 59.7%, at the good level in 35.55%, and at the moderate level in 5.3%. Observance of patients' rights was at the weak level in 13.6%, at the moderate level in 79%, and at the good level in 8.5%. Mean level of observance had significant relationships with sex [p < 0.02] and educational level [p < 0.03]. The relationship between knowledge and observance was significant at the 0.001 level. Data showed significant relationships between the experts' knowledge and observance in the domain of patients' rights. It is recommended to hold training courses on patients' rights for rehabilitation staff

[Relationship between social support with depression and anxiety during third trimester pregnancy]

This assumption is becoming increasingly accepted within scientific community that variations in fetal environment may have long-lasting over even permanent effects. Considering to alleviator factors of depression and anxiety seems necessary. The Aim of this study was to examine relationship between social support with depression and anxiety during third trimester pregnancy. In correlational study, 95 pregnant women in the city of Shiraz who were selected using several stage cluster sampling in summer of 1387 completed three questionnaires, Social Support, Depression and Anxiety during Pregnancy. To analyze, we used Pearson correlation coefficient and regression analyze. Data analysis showed a negative correlation between social support and depression of third trimester pregnancy [P=0.001], but no significant relationship between social support and anxiety during three trimester pregnancy was found [P=0.09]. Findings of this study show that depression third trimester pregnancy will decrease of increase if social support increase or decrease. This result can be used by the specialists who work with pregnant woman's mental health

[Comparison of honey dressing with hydrocolloid dressing effects on pressure ulcer healing of ICU hospitalized patients]

Bed sore is an important nursing diagnosis in patients in ICU which delay recovery and increase costs of patients and their family. The best method for bed sores is dressing. The aim of the study was to compare the effect of honey dressing with Hydrocolloid dressing on pressure ulcer healing in ICU patients. In this randomized clinical trial research, 29 patients with total of 40 pressure ulcers were participated. After selecting the patient based on inclusion criteria, hospitals were divided randomly in two control and intervention groups. Intervention group with total of 20 pressure ulcers were received bed sore care with honey dressing in Shohada hospital and control group with total of 20 pressure ulcers were received bed sore care with Hydrocolloid dressing in Farabi hospital. Ulcers state were measured with Pressure Ulcer Scale [PUSH] at the beginning of hospitalization and then weekly for 5 weeks. After intervention by comparing PUSH score in two groups, were measured. Data were analyzed by SPSS. The results showed that the two groups were statistically similar with regard to baseline and wound characteristics. After 5 weeks of treatment, patients who were treated by honey dressing had similar PUSH tool scores with patients that were treated with Hydrocolloid dressing. However, recovery in group with honey dressing was faster, but there was not any significant difference. Results showed that healing among patients that were treated with honey dressing were statistically similar with the comparison group. But easy accessibility, economical and neutrality makes honey dressing treatment as choice for pressure ulcers treatment

[Evaluation of clinical skills of medical emergency personnel in Tehran Emergency Center confronting the trauma]

Capability evaluation of medical emergency personnel, which is considered as one of the priorities in confronting the diseases, may provide an appropriate reflection of the performance of pre-graduation training programs and continuous training. The aim of this study was evaluation of clinical skills of medical emergency personnel in Tehran Emergency Center confronting the trauma. This descriptive study has been applied on 536 medical emergency personnel of Tehran Emergency Center. 213 persons were selected via stratified random sampling method. Data were collected through demographic questionnaire and "Clinical Skill Checklist". Content validity of the "Clinical Skill Checklist" has been evaluated and confirmed by 10 lectures and experts. Also reliability coefficient of all skills was equal to 0.803. The researcher observed the medical emergency personnel skills and then completed the "Clinical Skill Checklist". Data was analyzed with SPSS/17, statistical independent T tests, univariante variance analysis, Bonferroni post hoc test and correlation coefficient of Pearson. The results of the study indicated that 62.4% of the medical emergency personnel had good grade in trauma skill but practicing two skills of seated patient's spinal immobilization and traction splint had major skill deficiency. Between age, educational level, field of study, employment records and trauma clinical skill a significant statistical relationship existed [P<0.05]. Although in most skills, the medical emergency personnel had good grade skill, but it is required to provide necessary trainings in two skills that have not obtained sufficient point

[ effect of emotional intelligence education on job conflict in nurses]

Introduction: Today, conflict is an inevitable part of human communication in the health structures. One of the most important skills that are characteristic ability in conflict resolution is having emotional intelligence. Present research is an attempted to determine the effect of emotional intelligence training on conflict in nurses

Methods and Materials: The study was conducted using semi experimental applied design with control/trail group. Study sample included 56 nurses based on inclusion criteria sampling and in the next step balanced block randomization sampling was used for assigning 2 groups of: control group [n=29], and Trial group [n=27]. The researchers used 3 questionnaires including: Socio-demographic, Duberin Job Conflict Questioner and Bar-On Emotional Intelligence Questioner to gather data. Content and face validity of the questioners were measured by experts' nurses. The reliability [Cronbach's alpha] coefficients for these scales were: job conflict [85%] and emotional intelligence [95%] confirmed. At the beginning, of this study all participants completed the questionnaires as pretest, then EI skills in 6 hours presented only for trail group, one weeks [each week they got 2 education package] after intervention, all subjects [in 2 groups] again completed questionnaires. The statistical software used was SPSS [v.11.5] for windows. Also paired T, Chi-square and Hapker tested were used

Findings: Findings showed that there were no significant differences between the test and control group in terms of demographic characteristics except of marriage. Findings indicated that there are no significant differences between trail and control group in total and subscales EI score. However, finding indicated that there was a significant differences between before and after findings in trail group total and subscales EI score [p=0.049], and in job conflict [p=0.0001] and conflict score [p=0.000]

Conclusions: According to our findings in the present research, emotional intelligence education has been highly effective on the job conflict in nurses

[Correlation between organizational culture and burnout in the staff of Tehran province welfare organization]

Introduction: Burnout is the individuals' response to stress factors of work place and leads to changes in peoples' attitudes and behaviors toward work and environment. Aim of this study was to determine the correlation between organizational culture and burnout in the staff of Tehran province welfare organization

Materials and methods: In this descriptive-correlational study, 189 people were selected through random sampling. To collect data, demographic questionnaire,' Hofstede Organizational Culture Questionnaire' and 'Maslach Burnout Questionnaire' were used. To analyze the collected data by SPSS 12, Independent T-test, Mann-Whitney U, One-way ANOVA and Kruskal-Wallis were applied

Findings: The sample consisted of 38.1% male and 61% female .Results also showed that 9% of respondents were married. The mean age of the sample was 37.66[SD: 6.77] and the mean of employment years was 12.93[SD: 6.93]. In addition, findings revealed that, the characteristics of the organizational culture of the research community are as follows: cultural balance with a trend to masculinity, collectivism, fairly high uncertainty avoidance and highdistant of power. Burnout in emotional exhaustion and depersonalization was low whereas in personal accomplishment [frequency and intensity] were in medium levels. Analytic findings disclosed that the intensity of personal under-accomplishment was related positively and significantly with individualism-collectivism [P=0.03] and uncertainty avoidance [P=0.02]

Conclusion: The results suggested that organizational culture [individualism-collectivism and uncertainty avoidance] has a positive significant correlation with burnout [intensity of personal accomplishment]

Determination of facilitators and barriers in post stroke life, in Kerman city

Stroke is the third leading cause of death, second cause of long-term disability and one of the very important challenging in life. The aim of this research was to explain the barriers and facilitating factors affected on stroke patients' life, and to identify relationship among them with demographic factors and severity of disease. The descriptive-analytic technique was used. All patients who suffered from stroke were recruited in Kerman city. Finally 83 patients were selected, and data were gathered by demographic qualification questionnaire, proven questionnaire by researcher for studying barriers and facilitating factors [after testing validity and reliability], and NIHSS tools. Then, data were analyzed by using descriptive and referential statistics ANOVA test, T-Test, and Pearson coefficient correlation by SPSS software [ver. 16]. The findings showed that patients had more problems in the domains of politics, environmental factors, physical, and economic status. Also, they introduced social support from friends, family and prayer as facilitating factors in their lives. There was a significant positive relationship between age and physical and economical problems. Women have used social support and religious coping more than men. Married patients received more social support and their physical and economic problems raised less. Patients with higher severity of disease had more psychological problems such as depression and worry about future and Patients with lower socio-economic status more faced with barriers

[ Effectiveness of patient education and home-based follow up on knowledge and health behaviors in patients with myocardial infarction]

Patient education is a basic part of health care especially in chronic heart diseases in hospital and community. The present research intended to determine the effect of patient education and home-based follow up on knowledge and health behaviors in patients with myocardial Infarction referred to Modares health care facility in Kashmar. This is a quasi-experimental design, with two randomly selected groups. The experiment [n=18] and the control [n=20] group, were undergone a pre and post test. The health education program was carried out in 4 continuous sessions with different topics on cardiac events, diet, medication, coronary risk factors and exercise. The patients were given an instructional booklet containing the above mentioned information and were followed up at home for 3 times during 3 months. Data were gathered by knowledge measurement questionnaire and home-based follow up check list using interview and observation at the beginning of the study, during follow up, as well as at the end. The instructional booklet was given to the control group patients at the end of the study. The research findings indicated an improvement of knowledge in the intervention group patients [p=0.0001]. The comparison of mean scores between groups showed an improvement in knowledge and behavior as increase in the frequency [P=0.02], time of taking a walk [p=0.001], physical symptoms improvement during walking [P=0.03], recognition and avoiding from cardiac risk factors [p=0.001], following of diet [P=0.003], and medication regimen [p=0.001], reduction in need to extra visit by physician [P=0.001], as well as need to extra emotional support [P=0.000] in the intervention group. Health education to patients and internalizing it with reiterating, supervising, and managing by nurses in a familiar place as home can play as an effective factor in patients performance improvement, as well as community health development. It clarifies the community oriented role of nurses as a case manager in health-team

Comparison of fern and evaporation tests for detection of ruptured fetal membranes

Timely diagnosis of ruptured fetal membranes during the pregnancy is important. This study in the Islamic Republic of Iran compared the sensitivity and specificity of the evaporation test that requires no special equipment with the standard fern test requiring a microscope. Two groups of 50 pregnant women were studied: 1 with artificially ruptured membranes [gold standard] and 1 with intact membranes. The positive and negative predictive values of the fern test were 92% and 96% and for the evaporation test were 89% and 98%. The evaporation test is a simple, easy and non-expensive diagnostic test for ruptured membranes

[Survey of lameness in six dairy farms of Shiraz and marvdasht during one year period]

Descriptive study of lameness in some dairy farmsin Shiraz and Marvdasht in Pars Province.Descriptive study.624 cattle in six dairy farms.The dairy farms were selected on the basis ofowners' cooperation, type of production and predominantbreed [Holstine breed]. In the first step farmers wereinterviewed using a questionnaire to record the generalinformation of herd. A separate form was completed forevery affected cow according to history and clinicalexamination. This study was continued for a period of oneyear.The results of this study wereanalyzed descriptively.The results indicated that 13.74% of examinedcattle showed lameness. From that 4.8% were in winter, 4% in spring, 2.12% in summer and 2.7% in autumn.Lactating cows were most affected. 2-5 years old cowswere the most sensitive ones. Most of lesions were locatedin thedigital region [89.55%] showing72.10%inhindlimb, 46.48% in lateral claw of hind limbs.Bed condition, rainfall, age, hoof trimmingmanagement, no footbath, inadequate exercise and stage oflactation were determining factors in occurrence oflameness in this studyDescriptive study of lameness in some dairy farmsin Shiraz and Marvdasht in Pars Province.Descriptive study.624 cattle in six dairy farms.The dairy farms were selected on the basis ofowners' cooperation, type of production and predominantbreed [Holstine breed]. In the first step farmers wereinterviewed using a questionnaire to record the generalinformation of herd. A separate form was completed forevery affected cow according to history and clinicalexamination. This study was continued for a period of oneyear.The results of this study wereanalyzed descriptively.The results indicated that 13.74% of examinedcattle showed lameness. From that 4.8% were in winter, 4% in spring, 2.12% in summer and 2.7% in autumn.Lactating cows were most affected. 2-5 years old cowswere the most sensitive ones. Most of lesions were locatedin thedigital region [89.55%] showing72.10%inhindlimb, 46.48% in lateral claw of hind limbs.Bed condition, rainfall, age, hoof trimmingmanagement, no footbath, inadequate exercise and stage oflactation were determining factors in occurrence oflameness in this study